pneumonia

Question 1

How does pneumonia present?

Answer 1

Shortness of breath
Cough productive of sputum
Fever
Haemoptysis
Pleuritic chest pain
Delirium
Sepsis

Question 2

What are the signs sepsis?

Answer 2

Tachypnoea
Tachycardia
Hypoxia
Hypotension
fever
confusion

Question 3

What are the characteristic chest signs of pneumonia?

Answer 3

Bronchial breath sounds
Focal coarse crackles
Dullness to percusioon

Question 4

Describe bronchial breath sounds

Answer 4

Harsh breath sounds equally loud on inspiration and expiration. Caused by consolidation of the lung tissue around the airway

Question 5

What does CURB65 stand for?

Answer 5

Confusion
Urea >7
Respiratory rate >30
Blood pressure <90 systolic or <60 diastolic
Age >65

Question 6

What does the CURB65 score indicate?

Answer 6

Predicts mortality
0/1 consider treatment at home
>2 consider hospital admission
>3 consider intensive care assessment

Question 7

What are the two common organisms causing pneumonia?

Answer 7

Streptococcus pneumonias

Haemophilus influenzae

Question 8

What are other causes of pneumonia and their associations?

Answer 8

Moraxella catarthalis - immunocomprised / chronic lugn disease
Pseudomonas - Cystic fibrosis / bronchiectasis

Staph aureus - cystic fibrosis

Question 9

What is meant by atypical pneumonia?

Answer 9

A pneumonia caused by an organism which cannot be cultured

Question 10

How should atypical pneumonia be treated?

Answer 10

Macrolides (clarithromycin)
FLuoroquines (levofloxacin)
tetracyclines (doxycycline)

Question 11

What are the 5 causes of atypical pneumonia?

Answer 11

Legions of psittaci MCQs
Legionella - water, SIADH
Chylamydia psittaci - infected birds
mycoplasma - causes erythema multiform
Chlamydophila pneumonia - school aged child with mild to moderate chronic pneumonia and wheeze
Qs fever - Coxiella Burnetii - exposure to animals and their bodily fluids

Question 12

Describe pneumocystitis jiroveci

Answer 12

PCP
immunocompromised patients
dry cough, SOB and night sweats
Treatment with co-trimoxazole

Question 13

What are the investigations for pneumonia?

Answer 13

Chest xray
FBC (white cells)
U&Es (urea)
CRP (infection)
Sputum cultures
Blood cultures 
legionella and pneumococcal urinary antigens

Question 14

What are the potential complications of pneumonia?

Answer 14

Sepsis
pleural effusion
empyema
Lung abscess
Death